For couples who have been unsuccessful in their attempts to conceive, in vitro fertilization and embryo transfer allows them a chance at establishing a pregnancy.
Once a couple has been referred for assisted reproductive therapies and have been deemed good candidates for in vitro fertilization, both of them undergo a physical examination and assessment. Superovulation is a controlled technique, designed to stimulate the female partner’s ovaries to produce several oocytes in a cycle, rather than the usual single egg. Multiple eggs allow for multiple attempts at fertilization, and even the availability of multiple embryos. Superovulation ultimately increases the success rate of IVF and is thereby a common technique.
Medications used in superovulation include gonadotropin-releasing hormone agonists, follicle-stimulating hormone, luteinizing hormone, and human chorionic gonadotropin. These hormones are administered to the female partner by subcutaneous or intramuscular injection. With the resultant production of multiple ova, hormone levels of estrogen and progesterone reach levels that are much higher than normal, so there are frequent tests that are performed to monitor the body’s response to the medications.
While ovulation induction is taking place, follicular growth is tracked using transvaginal ultrasound. These vaginal sonograms may be repeated as the time for oocyte retrieval approaches.
Oocyte retrieval is performed while the patient is under sedation. The fertility specialist collects the ova by inserting a needle through the vaginal wall into the ovaries. This is usually facilitated by transvaginal ultrasound guidance to locate each follicle. Once the follicles are located, the follicular fluid and the eggs are aspirated into a test tube. The procedure takes about half an hour, and the patient is usually discharged within hours of retrieving the oocytes.
Semen Collection and Preparation of Sperm
The male partner submits a semen sample, usually through masturbation, on the same day of oocyte retrieval, and usually while the procedure is in progress. Abstinence from ejaculation anywhere from two to five days prior to collecting the specimen, to ensure a high sperm count at the time of collection. After the sample is collected, the sperm are prepared for inseminating the ova harvested from the female partner. In cases where producing a semen sample is not possible on the same day of oocyte retrieval, men can elect to have samples frozen in advance, or undergo testicular biopsy to extract sperm.